Utilization Management Advisor - Psychologist

The Judge Group; Philadelphia (Philadelphia County); Hybrid; USD 110,000 - 120,000; Full time

Benefits offered by this job

Health insurance

PTO and holidays

403B Retirement Plan

Short-term and long-term disability

Flexible spending accounts

Wellness Program

Employee Assistance Program

Job summary

The Judge Group is seeking a Psychology Advisor (Psychologist Advisor) in Philadelphia, PA for a hybrid role with in-office three days per week and standard business hours. This non-clinical, utilization-management position focuses on level-of-care decisions, quality oversight, and cross-functional collaboration rather than direct patient care.

Ideal candidates are licensed psychologists with deep ASD expertise and at least five years of experience in clinical settings, administration, and

Qualifications

• Doctoral degree in Psychology (Ph.D. or Psy.D.) from an accredited institution.
• Active, unencumbered license as a Psychologist in Pennsylvania.

Responsibilities

• Conduct rigorous clinical reviews across service settings to determine medical necessity and treatment appropriateness.
• Perform peer-to-peer reviews regarding disputed level-of-care determinations and complex cases.
• Evaluate community-based services and programs for children, adolescents, and families, ensuring adherence to evidence-based practices and regulatory mandates.

Skills

ASD expertise

Clinical consultation

Communication skills

Education

Ph.D./Psy.D. in Psychology

Job description

Highly sought after, non-clinical role as a Psychology Advisor for Utilization Management

Position Title: Psychologist Advisor

Position Type: Full-Time, Regular

Schedule: Monday – Friday (Standard Business Hours)

Work Arrangement: Hybrid (3 days/week in-office)

Location: Philadelphia, PA - IMPORTANT - Candidates must reside in a Philadelphia zip code, due to the contract with the city of Philadelphia.

Compensation: $110,000 – $120,000 / year

Reports To: Director of Psychology

Position Overview

The Psychologist Advisor serves as a core clinical subject-matter expert within a managed care environment, providing guidance to internal teams, behavioral health treatment providers, and community stakeholders. This is a administrative, consultative, and utilization management role—not a direct patient care position.

The ideal candidate is an experienced licensed psychologist with deep expertise in child and adolescent behavioral health, specifically Autism Spectrum Disorder (ASD). In this role, you will apply your clinical knowledge, evaluative expertise, and leadership skills to oversee level-of-care decisions, ensure high service quality, address complex clinical challenges, and optimize behavioral healthcare delivery across Philadelphia.

Key Responsibilities

• Conduct rigorous clinical reviews across various service settings and levels of care to determine medical necessity and treatment appropriateness.
• Perform peer-to-peer reviews regarding disputed level-of-care determinations and complex cases.
• Evaluate community-based services and programs for children, adolescents, and families, ensuring adherence to evidence-based practices, healthcare quality standards, and Pennsylvania regulatory mandates.

Clinical Consultation & Leadership

• Serve as a clinical consultant to behavioral health leadership, promoting a multidisciplinary approach to clinical decision-making.
• Advise internal teams responsible for provider network development, provider performance evaluations, and program integrity.
• Collaborate directly with community treatment providers and system stakeholders to address complex clinical scenarios, including placement barriers, treatment response issues, and care coordination challenges.

Quality Oversight & Training

• Participate in formal quality reviews related to member complaints, grievances, and targeted provider or agency audits.
• Represent Clinical and Medical Affairs in internal and external administrative and clinical meetings.
• Design and deliver clinical training and educational sessions for internal teams, care managers, network providers, and external stakeholders.
• Provide subject-matter expertise on cross-functional initiatives aligned with professional expertise and organizational priorities.

Position Requirements & Qualifications

Mandatory Requirements

• Residency: Due to the contract with the city of Philadelphia, employee MUST currently reside within a Philadelphia city zip code.
• Education: Doctoral degree in Psychology (Ph.D. or Psy.D.) from an accredited institution.
• Licensure: Active, unencumbered license as a Psychologist in the Commonwealth of Pennsylvania.
• Specialized Expertise: Demonstrated clinical expertise in Autism Spectrum Disorder (ASD), including multi-faceted assessment, diagnosis, evidence-based treatment strategies, and the behavioral health needs of children and adolescents with autism.

Required Experience

• Clinical Experience: Minimum of 5 years of experience as a Psychologist, providing psychological services to children, adolescents, and families across home-based, community-based, and/or school-based settings.
• Consultation & Administration: Minimum of 5 years of experience providing clinical consultation, supervision, and program administration.
• Evaluation: Proven track record of conducting comprehensive biopsychosocial evaluations, establishing formal mental health diagnoses, and collaborating with multidisciplinary teams.
• Extensive knowledge of managed healthcare systems, utilization management, and quality improvement principles.
• Strong written and verbal communication skills, with the ability to convey complex clinical concepts to both clinical and non-clinical audiences.
• High degree of professionalism, collaborative problem-solving, and sound administrative decision-making.
• Medical, prescription drug, dental, and vision insurance
• Paid Time Off (PTO), paid holidays, and sick days
• 403B Retirement Plan
• Short-term and long-term disability coverage
• Family planning, fertility, and adoption benefits
• Wellness Program
• Employee Assistance Program
• Flexible spending accounts
• And more!

For additional information regarding this opportunity, please contact:

Holly Benson

151 S. Warner Rd, Suite 100, Wayne, PA 19087